Q-switched 532 nm Nd:YAG laser therapy for physiological lip hyperpigmentation: novel classification, efficacy, and safety.

BACKGROUND: Physiological lip hyperpigmentation (PLH) is a common cosmetic concern in the Middle East and Asia. It is characterized by homogeneous symmetric diffuse hyperpigmentation affecting both lips. There is no satisfactory treatment for this condition. The aim of this study is to evaluate the efficacy and safety of Q-switched (QS) 532 nm Nd:YAG laser for PLH. METHODS: A total of 30 patients with clinical diagnosis of PLH were retrospectively reviewed and included in the study. Patients underwent at least one laser treatment using QS 532 nm with a minimum follow up of six months. Laser parameters were as follows: spot size 2-3 mm, pulse duration 20 ns, fluence 2-4 J/cm2. One to three sessions were performed depending on clinical response. Two methods were used for assessment: patient satisfaction and independent physician assessment. PLH was classified as grade 1 (upper lip fully affected plus only border of lower lip), grade 2 (upper lip fully affected plus most of lower lip), and grade 3 (majority of both lips hyperpigmented). RESULTS: Excellent (>75% improvement) response was achieved in 30% of patients. Good (51-75% improvement) response was seen in 37% and 43% of patients according to patient satisfaction and independent physician assessment, respectively. Majority of patients required only one treatment session. Reactivation of herpes labialis occurred in two patients, and mottled hypopigmentation in three patients. None of the patients developed persistent hyperpigmentation or scarring. CONCLUSIONS: PLH can be effectively treated with QS 532 nm Nd:YAG laser and is well tolerated by patients.

Novel drug delivery approaches for the management of hair loss.

Introduction: Alopecia is a common clinical complaint for patients and often a source of significant psychological distress. The goal of therapy is to stop hair loss and encourage regrowth. Many treatment modalities are available and novel drug delivery approaches are needed to maximize results and minimize potential side effects.Areas covered: Many novel drug delivery approaches for the management of hair loss have been developed in recent years. This review summarizes all therapeutic modalities used to enhance drug penetration into the scalp including microneedling, laser-assisted, radio-frequency, sonophoresis, iontophoresis. Advantages and developments in nanoparticles drug delivery approaches are also discussed.Expert opinion: When considering novel drug delivery approaches for alopecia, physicians should consider the intended target and etiology of hair loss.